Out of breath while walking - British Heart Fou...

British Heart Foundation
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Out of breath while walking


I am 25, male, sedentary lifestyle, live in UK. My diet is mostly protein and fats, less than 100g carbs a day. I decided to get into healthier lifestyle and wanted to start running, but was met with feeling dizzy, chest pain and pressure, headache and weakness, shortness of breath.

Hence, I decided to switch to walking but 10 minutes in slow pace, I get same symptoms. Are those cardiac in origin or me being so out of shape? I have been checked a year ago by a cardiologist, who did resting and stress ECG, along with echocardiogram. I was told my pulse went to 186 bpm and it is too high for the activity level. Otherwise, all was okay.

I then had another echocardiogram, this time in ER when I had my blood pressure rise to 150/100, feel sweaty and unwell. I was told it is a panic attack, and that my anxiety and depression needs to be controlled. I then went on to live sedentary lifestyle, and those symptoms cropped up after deciding to exercise again.

My family has a history of high blood pressure, a grandmother had a pacemaker at 69 years old. My mother has hypertension, controlled by medicine. My father is fine at age 55. I had a lot of ECGs over the past year due to panic/anxiety attacks, it felt like my heart is going to explode. They were always normal, they never registered cardiac enzymes.

I would like to ensure that my heart did not get diseased in the last 6 months doing this low car diet. What are the tests to ask for? I would like to know that this is not cardiac origin. Every doctor in ER multiple times said it is not cardiac and that I need to deal with my anxiety somehow.

13 Replies

You need to see a health professional regarding medical matters.

If your heart rate was too high for the activity you were doing, you may have had a problem a year ago, they just didn't identify what it was.

Are your carbohydrates mostly from vegetables? Is it possible you have a micro-nutrient deficiency? Too much protein is as unhealthy as too many carbohydrates; the excess amino acids stimulate TOR, increasing IGF-1 and are easily converted to glucose.

See phcuk.org/wp-content/upload...

Are your ingested fats natural, or man-made oils? Are they predominantly monounsaturates, with only small amounts of EFAs?

My carbs are from vegetables. I eat only natural fats: lard, tallow, olive/coconut oil, and fat is various meats. I eat salmon 3 times a week. Vegetables : spinach, kale, brocolli, cauliflower, radish, cucumber, leeks, onions, watercress. I eat a lot of meat and do not eat dairy, eggs or nuts.

Your diet seems fine. Anxiety can cause problems which can mimic heart disease. Also, I find even if I miss my cardiac rehab classes for one week I become less fit so if you've been sedentary for a while it's logical you won't be able to do what you did before. Why don't you ask your GP or cardiologist to refer you to a local cadiac rehab class? They are usually fairly inexpensive to attend and you may get a free trial. If you've had everything tested you are probably just worrying too much but being in a class with an experienced trainer would help you.

I wouldn't describe 100g of carb as a low carb diet. I've been on a keto diet for the last two weeks, and the upper limit is between 20 - 30g of carbs if you're eating exclusively green veg for your carbs, it's damn near impossible to reach 100g of carbs in a day.

I too have had similar cardiac symptoms to the ones you describe, and I too am a young male. I had a 24 hour ECG which showed nothing really note worthy. The said there was a slighty anomaly with the electrical pulse on the right side of my heart, but it was nothing to warrant further investigation. I also had a blood test for heart failure. I forget the name of the peptide, BNP or something like that. Anyway, that came back at 31, so heart failure was ruled out.

One of the most recurring symptoms I had was hearing my pulse in my ears. This started when I was exercising regularly, and seemed to improve when I stopped. I also noticed a reoccurrence when I started my low carb diet. However, it seems to have gone after I stuck with it.

I'm going to the doctors in a few weeks to say that I'm still having problems with my heart. I don't expect to get much help to be honest.

How fast / far were you running on the stress test? When I was running my regularly, I noticed that my pulse would regularly reach a little over 180.

I don't know about running, it was a bicycle. I was told I reached level 3 out of 5 and that my pulse should not have gone to 180s on that. I was sweating a lot as well and was told I am out of shape and to do something about it.

Did they check you for blood pressure? I had quite a few trips to ER due to other reasons last 1 months, and it seemed to be always raised on the systolic side. Anyways, I am flying back to my home country for holidays, and will go to the same cardiologist for an assessment next Monday. I hope it is still me being lazy and untrained. With regards to your new diet, please make sure to get a baseline of cholesterol levels. It is very important because people with certain genosets respond negatively to additional fat in the diet, read about APOE4 - lean mass hyperresponder. I have my suspicions that keto might not be for me because my cholesterol number that most important TG / HDL ratio, slightly worsened over the last 10 months. It kind of coincided with heart symptoms as well so I want this checked out.

However, I had episodes of higher blood pressure way before low carb diet, so I do not think that it did much to worsen the situation. I think the cardiologist should have done something about it a year ago, but I hope to convince her that is the problem next week.

I was watching a YouTube video the other day by a doctor that follows a keto diet himself. He was explaining that higher cholesterol isn't necessarily a bad thing. He said your cholesterol will go up, but the ratios of good to bad cholesterol will be much improved. Besides which, I've lost nearly two stone on a low carb diet since this summer.

My average blood pressure is 115 over 71. When I was having bad heart symptoms, I found that my diastolic blood pressure was quite low, but my systolic remained where it should be.

That is my problem, my ratio got worse. My HDL lowered, LDL upped along with trigs. I might have genotype in APOE gene that is known to cause this. One problem is that it is discussed that usually such people are hyperresponders where their cholesterol goes way up but is balance by lowering trigs and upped HDL. My lab parameters are not like that. Total chol is at upper boundary, same for LDL, HDL went down and trigs increased. Everything is just bad about this change.

A CT scan can be used to give the CAC score. This looks directly into the heart/coronary arteries to see any accumulation of calcium/atherosclerosis.

mrblue12 in reply to Concerned

The chances of a doctor giving a 25 year old a CT scan for atherosclerosis are slim to none. They kick out a lot of radiation. It's like having 100 X-rays. The risk vs reward isn't high enough.

Yes, there is no way NHS will do that for me at such an age from what I read. They do not like spending public money on low probability of a problem. I read research that 99% of men below 30 have 0 score, so me having a problem is very low. From what I understood medicine relies heavily on probabilities and odds ratio to judge a patient.

There’s lot of research to prove that managing anxiety and stress will go a long way to improve physical symptoms. In my experience I find if I get overwhelmed or worry about physical symptoms and so on I can exacerbate them. I’ve learned and continual learning how to manage my thoughts and emotions. Typical ( current) example due to taking statins and aware of side effects I literally talked myself into the symptoms occurring thus BP went up hugely and I had a burst blood vessel behind the eye. Glad to say all managed well. AND I am off the statins!

Glad you are fine. To be honest, it seems like I now expect my chest to hurt after the attempt to run, and it usually happens. When I move my chest around, I can feel stabbing pain so maybe it is muscular origin. I still feel like my blood pressure concerns are genuine and I hope next week, a specialist can help me deal with this.

Yes all of that may be so! I really do empathise yet in learning to relax stop looking for further twinges and so on will mean you can relax and go into the pain it lessens and the body relaxes which means body tension eases and you break the vicious circle? If we are anxious everything overwhelms Google some of the great relaxation music or 528mgz sounds to relax the brain? I've got some favourites ones ... That was the beginning of relaxation plus listening to relaxation and meditation utube stuff? Good luck you CAN take back control. Promise!!

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